Brain perfusion SPECT in juvenile neuro-Behçet's disease

S. Vignola, F. Nobili, P. Picco, M. Gattorno, A. Buoncompagni, P. Vitali, G. Mariani, G. Rodriguez

Research output: Contribution to journalArticle

Abstract

Regional cerebral blood flow was evaluated by 99mTc-hexamethylpropyleneamine oxime SPECT in 7 patients (age range, 7-18 y; mean age, 9.1 y) affected with Behçet's disease and signs or symptoms of central nervous system involvement at different times of their clinical history. Methods: Three patients suffered from seizures, 3 patients were affected with severe persistent headache that was refractory to common analgesic and nonsteroidal antiinflammatory drugs, and 1 patient had recurrent episodes of acute intracranial hypertension. Electro-encephalography was performed on all patients, MRI on 5 patients, and CT on 1 patient. Brain SPECT was performed using a high-resolution, brain-dedicated camera. After conventional visual analysis by 2 expert readers, 2 transaxial sections were drawn parallel to the bicommissural line: the first across the thalami and the second across the temporal lobe at the level of the mesiotemporal structures. Cortical regions of interest were drawn automatically on the cortical ribbon on the 2 sections, whereas other regions of interest were drawn by hand around the basal ganglia, the thalami, and the mesiotemporal structures. Asymmetry analysis was then applied, and hypoperfusion was considered when the asymmetry value was >10%. Results: Hypoperfusion was observed in all patients by visual and asymmetry analyses; this finding was localized mainly in the basal ganglia, the thalami, and the temporal cortex, including its mesial portion. Temporal hypoperfusion was found primarily in patients with seizures, and hypoperfusion of deep gray nuclei was found mainly in the other patients. Electroencephalography disclosed brain functional impairment in 5 of 6 patients, whereas MRI showed multiple bilateral white matter lesions in 1 patient suffering from persistent headache. Conclusion: As in adults, perfusion SPECT seems to be very sensitive in disclosing brain abnormalities in children and adolescents with Behçet's disease and signs or symptoms of central nervous system involvement, even with negative findings on brain MRI.

Original languageEnglish
Pages (from-to)1151-1157
Number of pages7
JournalJournal of Nuclear Medicine
Volume42
Issue number8
Publication statusPublished - 2001

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Keywords

  • Brain SPECT
  • Juvenile Behçet's disease
  • Neuro-Behçet's disease
  • Pediatrics
  • Regional cerebral blood flow

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Vignola, S., Nobili, F., Picco, P., Gattorno, M., Buoncompagni, A., Vitali, P., Mariani, G., & Rodriguez, G. (2001). Brain perfusion SPECT in juvenile neuro-Behçet's disease. Journal of Nuclear Medicine, 42(8), 1151-1157.